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Minister of Health, Dr Aaron Motsoaledi says National Health Insurance (NHI) is just part of a ten point plan to improve healthcare in South Africa.
“This is not about public or private, it’s about the performance of the entire healthcare system,” he said at the Hospital Association of South Africa’s annual conference. “We can’t run away from NHI.”
He asked the private sector to assist government in three key areas: the implementation of NHI, improvement of human resources management to help reduce mortality due to HIV, tuberculosis and other communicable diseases.
Motsoaledi said for the next five years the department of health would deal with the restructuring of the healthcare system, including ensuring that sufficient human resources were made available.
The first phase of the NHI
He said during this first phase specialist teams at district levels would be appointed including a gynaecologist, midwife, anaesthetist, paediatric nurses and other healthcare professionals to take care of all hospitals in each of South Africa’s 52 districts. “I want to bring back retired specialist and professors,” he added.
He said a complete transformation of healthcare service provision and delivery was needed including the total overhaul of the entire healthcare system as well as the radical change of administration and management. The provision of a comprehensive package of care underpinned by a re-engineered primary healthcare was also an important pillar.
Motsoaledi said the cost of private healthcare was out of control at the expense of medical scheme members, and the cost of public healthcare was escalating at the expense of the fiscus.
“Our healthcare system is not efficient, appropriate nor affordable or we wouldn’t have so many mothers and children dying,” he said.
Other areas the department is focusing on include a review of the drug policy; revitalisation of physical infrastructure; improving quality of service; and strengthening the country’s research and development capacity. Motsoaledi also declared war on products which negatively affect health, such as alcohol and tobacco products.
NHI and estimated costs
He said the NHI would be funded through a combination of sources including the ficsus, employers and individuals. The revenue base is to be as broad as possible to achieve the lowest contribution rates and to generate sufficient funds to supplement the general tax allocation to NHI.
“When it comes to estimated costs, we will see what happens in the next five years and will adjust from there,” he added.
He said medical schemes will continue to exist side by side with the NHI and may provide top up cover, with no-one being allowed to opt out of the NHI. “I want NHI to work for 100% of the population,” he said.
HASA Chairman Dr Nkaki Matlala said private hospitals supported universal coverage and hoped that it would be home grown and that stakeholders would be consulted.
“We know universal coverage does not mean the death of private services,” Matlala said. “We need to find a way of contributing positively.”
(Press release, September 2011)
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NHI proposals 101
